Nurses are often the main source of health education in rural areas and are uniquely suited to address the lifestyle behaviors needed to promote heart health among rural women. Nurses working with individuals are able to assess and implement stage-matched interventions while personalizing the message to the individual and their rural communities. Community interventions (Cl), designed with community members, in conjunction with nursing interventions strengthen the message of adopting heart healthy lifestyles for rural women. The overall purpose of this 14-month study is to compare the effectiveness of a stage-matched nursing and community intervention (SMNCI) with a standard Cl in modifying the dietary intake, physical activity (PA), and smoking in rural women, aged 45-65 years. The Specific Aims of the study are to determine whether: 1) those rural women who receive SMNCI have greater healthy lifestyle changes in dietary intake, PA, and /or smoking than those who receive only Cl; 2) SMNCI will be more successful than Cl alone in moving a larger proportion of rural women forward through the stages of change for behavioral [unreadable] [unreadable] action relative to dietary intake of fats, fruits, vegetables and fiber; PA; and smoking; 3) SMNCI will be more successful than Cl alone in improving selected modifiable cardiovascular (CV) risks and measurable anthropometric outcomes including blood pressure, weight/body mass index, central adiposity and cholesterol; 4) SMNCI will improve the coronary heart disease risk score and health related quality of life more than Cl alone; 5) order of treatment, SMNCI followed by Cl alone is more effective than Cl followed by SMNCI. A purposive sample of 176 rural women (88 Caucasian from NY and 88 African American women from VA) will be studied. Women will be assigned to the SMNCI group using a random approach during two enrollment periods. Primary measures of stage of change (SOC) and actual behaviors in the area of diet, PA, and smoking will be evaluated at baseline and 14 months. Process measures of SOC and selected anthropometries will also be taken at 7 months. Stage of change will be used to choose appropriate stage matched interventions from a pre-developed template. Intervention includes 4 RN visits, 5 group meetings, and phone contact (2x month) over the 14-month period. Cl will include a community visioning strategy. Cl will occur for half the sample at the beginning and half at the end of their enrollment periods. [unreadable] [unreadable] [unreadable]